The committee evaluated childhood nutrition programs up for reauthorization and sought input from government officials, medical experts, and education coordinators at a hearing on Thursday. (A list of all programs up for review may be seen here.)

"Nutrition, at its core, is preventative medicine," she said. "And child nutrition is about leveling the playing field so that a baby, a child, a teen -- in Detroit or a rural town in Kansas, or a suburb of Atlanta, or farm in Iowa -- has every opportunity to be healthy and successful."

Stabenow sees things improving. Children now eat 16% more vegetables and 23% more fruits, according to a Harvard School of Public Health report. But there's still more work to be done, she added.

Cindy Jones, business management coordinator for school nutrition programs for the Olathe Public Schools in Olathe Kansas, the second largest school district in the state, said after implementing "universal breakfasts" fewer students came in late or missed school, and they seemed better behaved.

Yet, recent revisions to school nutrition standards have tempered these successes.

"Despite our best efforts to make meals more appealing, we are struggling with student acceptance," Jones said.

Since more stringent nutrition requirements were enacted participation rates have fallen by 9% in elementary schools and some children have begun bringing meals from home. The paid lunch equity mandate under the Healthy Hunger-Free Kids Act also prompted some schools to raise lunch prices. For one young student this meant her family could only afford school meals 2 days per week, Jones said.

Moreover, Jones estimates her school has lost $700,000 in "a la carte" revenues after the Smart Snacks in Schools program was implemented.

Because of more rigid requirements, certain a la carte items were scratched from the menu, such as a salad with "small amounts of meat, cheese, and salad dressing" that kept it from meeting standards for sodium and fat content. Also eliminated was a formerly popular sub sandwich -- after it was shrunk, stripped of cheese, and made with whole wheat bread to meet the new standards, it lost its appeal to kids and hence its market.

Jones asked the committee to allow schools to return to the 50% requirement for wheat products and that more stringent sodium standards not be enacted.

She also said the requirement to give every children a half-cup of fruits or vegetables each day may be counterproductive. Even if two-thirds of the students eat the serving, there are still 10,000 cups thrown away. The waste could prompt her schools to drop the products entirely.

"I would hate for those students who want to eat their fruits and vegetables to lose that option, because others are forced to take them and just throw them in the trash," Jones said.

But Richard Goff, executive director for the office of child nutrition for West Virginia's Department of Education, was more sanguine about the current requirements.

Sixty percent of children in West Virginia are eligible for free or reduced-priced meals, Goff noted.

When the state was passed over for a series of "community eligibility" pilot projects in 2011-2012, by the US Department of Agriculture, West Virginia developed its own version, instituting the "WV Universal Free Meals Pilot Project." (The USDA selected West Virginia the following year.) In 2013, West Virginia became the first state to enact a bill that focused on children's nutrition in education settings, noted Goff's written testimony, the "West Virginia Feed to Achieve Act."

Initially Goff's schools faced many of the problems Jones described, he told the committee, but complaints about skim and low-fat milk receded in time and students started requesting "brown bread."

She opened a childhood weight management practice 27 years ago. "When I retired last October, I had a special clinic for children under 5 with obesity, and we were seeing infants," she told the committee.

She stressed the importance of reauthorizing the WIC program and lobbied to expand a breast-feeding peer counseling program. She noted that children involved in WIC have enhanced birth outcomes, higher immunization rates, and better access to healthcare. It may even reduce obesity rates, she said.

Regarding the school lunch program, Hassink told MedPage Today, it's still in transition.

"Rome wasn't built in a day," she said, noting that kids can't be forced to eat healthy foods. On the other hand, she said, offering them free access to less-healthy but desirable foods makes it more difficult for them to make good choices.

"Going back to what I tell parents, the first thing you do is get your home environment healthy. If you don't want your child to eat it, don't have it," she said.

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.